Group members- Amelia, Audrey, David and Libby.


PTSD

Thesis- PTSD is a serious mental health condition that affects a very broad range of people, including children, and while the disorder has been in existence for nearly as long as humans have been around, it has only recently been diagnosed.


Basics
  • Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Causes

  • War

  • Assault

  • Rape

  • Domestic Abuse

  • Terrorism

  • Prison Stay

Symptoms

Symptoms of PTSD fall into three main categories:

1. "Reliving" the event, which disturbs day-to-day activity

  • Flashback episodes, where the event seems to be happening again and again

  • Repeated upsetting memories of the event

  • Repeated nightmares of the event

  • Strong, uncomfortable reactions to situations that is a reminder of the event

2. Avoidance

  • Emotional "numbing," or feeling as though you don't care about anything

  • Feeling detached

  • Being unable to remember important aspects of the trauma

  • Having a lack of interest in normal activities

  • Showing less of your moods

  • Avoiding places, people, or thoughts that remind you of the event

  • Feeling like you have no future


3. Arousal

  • Difficulty concentrating

  • Startling easily

  • Having an exaggerated response to things that are startling

  • Feeling more aware (hyper vigilance)

  • Feeling irritable or having outbursts of anger

  • Having trouble falling or staying asleep History of PTSDTopic Sentence- While the term PTSD and the diagnosis of this disorder are relatively recent developments, the concept of PTSD has existed for thousands of years.Nancy C. Andreasen, of the Annals of the New York Academy of Sciences, explains that PTSD's history has often been linked to the history of war, but the disorder has also been frequently described in civilian settings involving natural disasters, mass catastrophes, and serious accidental injuries.

  • Symptoms attributed to PTSD have been written about for thousands of years.



  • Some notable PTSD realizations were attributed to Homer in the Illiad, and Shakespeare in Macbeth, both deal with extremely strenuous events.



  • A bit later in 1666, Samuel Pepys, a member of parliament, famously wrote in a diary about his emotional state after the London fire of 1666, saying he suffered from “sleep disturbances, fear feelings, and intrusive memories that haunted him for a long time.”


    samuel pepys
    samuel pepys



  • These men recognized what was causing the symptoms they had seen, but they were unable to generalize their findings to a larger discovery.



    1800's
  • Dr. Mandez Da Costa, and "soldier's heart".



  • These positive steps toward acknowledgement and understanding of PTSD took a step back in the early 1900's during the world wars.



    Early 1900's
  • After WWI the term shell shock was introduced for veterans in England suffering from PTSD like symptoms. “Between 1914 and 1918, the British Army identified 80,000 men as suffering from shell shock. Shell shock was seen as a sign of emotional weakness or cowardice.”


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  • “More than 300 British soldiers, many suffering from “shell shock,” are executed for cowardice.”



  • WWII



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  • In 1943, “U.S. Army
 Lt. Gen. George S. Patton, visiting wounded soldiers in a hospital in Sicily, asks one to describe his injuries. “It’s my nerves,” the soldier replies. Patton slaps him across the face and calls him a coward.”

Late 1900's
  • DSM I (1952) First official mention of a stress response syndrome.

  • DSM II (1968) Stress related disorders omitted from DSM

  • In 1980, the American Psychiatric Association added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III).

  • It is interesting the time periods of when PTSD type disorders were included in DSM.

  • The 1980 edition of the DSM was the foundations of what we see in the diagnosis of PTSD today.



PTSD Today

As Post Traumatic Stress Disorder becomes more widely known, the number of reported cases also seems to be increasing. Today, more than seven million Americans are diagnosed with PTSD, and clinics are offering their support in return.

  • Soliders are now able to get a PTSD screening when they return from war.

  • PTSD screenings are offered at 88 primary care clinics nationwide.

  • When soldiers go to clinics for other matters, they are asked to fill out a form to determine whether they have PTSD.

  • Soldiers who test positive for PTSD are given a treatment plan.

  • In 2011 the Department of Veteran Affairs reported that there was a 6-7% increase in the number of PTSD cases, about 9,000 new cases every three months

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Full-size image (9 K)
Full-size image (9 K)


  • This chart does not show a growth in cases, but shows an increase in the number of articles written on Post Traumatic Stress Disorder. This shows us that PTSD is becoming more widely heard of and well recognized.


Some treatments for PTSD include:

  • Various types of Psychotherapy

  • Prescribed Medication

  • Alternative Medicine










PTSD and Children

PTSD not only drastically influences the lives of adults, but also children. Children and adults suffer similar symptoms as adults, but a child is at risk of developing a future mental illness, such as depression and a panic disorder.


  • Children develop PTSD when the situation is perceived as life threatening or extremely dangerous

  • The child will either respond with extreme:

    • Fear

    • The feeling of helplessness

    • Horror

Factors that contribute to childhood PTSD

  • How close the child was to the actual traumatic event

  • Was the child involved?

  • Did the child witness the trauma as it was happening?

  • How close was the child involved with the victims

    • Did the trauma involve the child’s immediate family?

  • The severity of the traumatic event

  • How long the traumatic event lasted

Symptoms of Childhood PTSD

  • Feeling and acting like the traumatic event is happening again

  • Acting younger than their age

  • Losing interest in activities

  • Increased alertness

    • Children believe there were signs that the trauma/traumatic event were going to happen. They search for those signs in everyday life.

    • Children believe that if they pay attention they can anticipate future trauma

    • Repeating behavior that reminds them of the trauma

    • Avoidance

    • Upsetting or extremely frightening dreams

Symptoms for Younger Children (who cannot express feelings verbally)

  • Out of control disruptive behavior

  • Extreme fear of being separated from their parent

Treatment for Childhood PTSD

  • Cognitive behavioral therapy

    • The number one treatment which applies that our thoughts and feelings influence our behavior

  • Play Therapy

    • Uses hand on materials to help younger kids process traumatic memories

  • Talk therapy

    • Help the child remember the traumatic event safely dealing with grief, guilt, anger, depression, anxiety, or behavioral issues

  • Family Therapy

    • Establishes a safe environment for the child, also creates a support system


Sohrab and PTSD
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There are a number of factors contributing to Sohrab's behavior that support PTSD symptoms.

Causes of PTSD

  • The murder of his parents

    • Witnesses their murders

  • Living in an orphanage

    • Being bought by Assef

      • Repeated abuse- sexually and mentally

  • Witnessing Amir getting beat close to death

    • Shooting Assef in the eye

Sohrab’s Signs of PTSD

  • Silence

    • “Silence that sucked everything in like a black hole.” pg 363

  • Constantly Tired

    • Frequently sleeps throughout social situations

  • Bursts of Emotions

    • "Please! Please, no!" he croaked. "I'm scared of that place. They'll hurt me! I don't want to go." (pg 341)

  • Constant fear of repeating the trauma he experienced

    • Extreme fear of being placed in an orphanage again

    • Results in a suicide attempt

  • Difficulty Maintaining Close Relationships

    • After Sohrab and Amir become close, Sohrab cuts himself off from everyone.

    • "So I left the room and went looking for another hotel, unaware that almost a year would pass before I would hear Sohrab speak another word." (page 356)

  • Overwhelming Guilt or Shame

    • "Because I don't want them to see me...I'm so dirty." He sucked in his breath and let it out in a long, wheezing cry. "I'm so dirty and full of sin." (pg 319)


Treatment for Sohrab

  • A stable home environment

    • Amir gives Sohrab a stable home, but does not provide help for Sohrab’s PTSD

  • Cognitive behavioral therapy or family therapy for both Amir and Sohrab


Wrap up-

Definition- Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

1. PTSD can occur from many other events than just war, such as domestic abuse, rape, prison stay, mass catastrophes, and serious accidental injuries

2. PTSD has a long history and was only recently given its due attention as a serious medical disorder.

3. PTSD can affect children differently than adults, possibly putting them at risk of developing a future mental illness, such as depression or a panic disorder.



Sources:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/
http://www.childrenshospital.org/az/Site1470/mainpageS1470P1.html
http://www.uic.edu/cuppa/gci/publications/workingpaperseries/pdfs/anderson%2005-04.pdf
http://www.ptsd.va.gov/public/pages/ptsd-children-adolescents.asp
http://www.ptsd.va.gov/public/pages/ptsd-children-adolescents.asp
http://www.stripes.com/news/soldiers-seeking-routine-medical-care-now-get-ptsd-screening-as-well-1.182194
http://usatoday30.usatoday.com/news/military/story/2011-11-29/PTSD-cases-rise/51476604/1
http://www.brainline.org/content/2011/01/posttraumatic-stress-disorder-a-history-and-a-critique_pageall.html
http://protomag.com/assets/ptsd-timeline-centuries-of-trauma
http://www.lankaweb.com/news/items/2011/01/07/the-history-of-ptsd/